BILL ANALYSIS Ó
AB 485
Page 1
CONCURRENCE IN SENATE AMENDMENTS
AB 485 (Gomez)
As Amended February 18, 2014
Majority vote
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|ASSEMBLY: | |(May 30, 2013) |SENATE: |26-7 |(February 24, |
| | | | | |2014) |
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(vote not relevant)
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|COMMITTEE VOTE: |5-1 |(August 5, 2014) |RECOMMENDATION: |concur |
|(Human Services) | | | | |
| | | | | |
|-----------------+-----+--------------------+----------------+----------|
|COMMITTEE VOTE: |12-4 |(August 15, 2014) |RECOMMENDATION: |concur |
|(Appropriations) | | | | |
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Original Committee Reference: P.E., R. & S.S.
SUMMARY : Disconnects implementation of statewide collective
bargaining authority for the In-Home Support Services (IHSS)
program from the state's Coordinated Care Initiative (CCI) and
implements it separately under the new statewide California IHSS
Authority (Statewide Authority) beginning January 1, 2015.
The Senate amendments delete the Assembly version of this bill, and
instead:
1)Require the Statewide Authority to assume collective bargaining
responsibility for IHSS providers in all counties beginning
January 1, 2015, rather than in the eight counties participating
in the CCI demonstration project.
2)Make the Statewide Authority permanent by deleting statute making
statewide collective bargaining conditional upon implementation
of the CCI.
3)Delete statute authorizing the Director of Finance to halt
implementation of the CCI and therefore statewide collective
bargaining by the Statewide Authority if the director determines
that the CCI will not generate anticipated General Fund savings.
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4)Make permanent through the separation of statewide collective
bargaining authority for IHSS:
a) The IHSS Maintenance of Effort (MOE) requirement for all
counties in lieu of their share of non-federal costs; and
b) The existing requirement that each county's IHSS MOE count
toward its share of cost of negotiated wage and benefit
increases.
5)Eliminate from the list of codes that will become inoperative, if
the CCI is rendered inoperative because of a lack of General Fund
savings, various codes relating to the Statewide Authority,
including those that establish the IHSS Employer-Employee
Relations Act, establish and define the duties of the Statewide
Authority, and require all counties to have a county IHSS MOE.
6)Make other technical and aligning changes to existing CCI
statutes to disconnect statewide IHSS collective bargaining
contingency language from the implementation of the CCI.
AS PASSED BY THE ASSEMBLY , this bill ratified the provisions of a
memorandum of understanding between the state and State Bargaining
Unit 16, Physicians, Dentists, and Podiatrists.
FISCAL EFFECT : According to the Senate Appropriations Committee:
1)Potentially major ongoing costs (General Fund) in the tens to low
hundreds of millions of dollars to the extent the provisions of
this bill result in an increase in IHSS provider wages and health
benefits with the implementation of the Statewide Authority in
all 58 counties effective January 1, 2015. As only those wage
and benefit increases that are locally negotiated or imposed
before the Statewide Authority assumes employer responsibility
result in an adjustment to the County IHSS MOE, any increases
negotiated by the Statewide Authority do not require a county
share of costs. The non-federal share of costs will be fully
funded by the state, resulting in major ongoing costs to the
General Fund.
2)Annual costs in the range of $6.9 million (50% General Fund, 50%
federal funds) to the Department of Human Resources (CalHR) to
implement and operate a collective bargaining platform on behalf
of the Statewide Authority expanded to cover all 58 counties
effective January 1, 2015.
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3)Additional one-time significant costs (General Fund) to CalHR for
limited-term staff and overtime required to support the workload
imposed under the accelerated implementation date mandated in
this bill.
4)To the extent the CCI will have otherwise become inoperative at
some future date due to an estimate by the Director of Finance
that the CCI will not generate net General Fund savings, as
specified, the annual costs noted above would continue to be
incurred. The counties' share of cost limited by the County IHSS
MOE will not revert to the original cost-sharing formula, and
CalHR/DSS [Department of Social Services] costs will continue to
support the activities of the Statewide Authority.
COMMENTS :
Background on IHSS: The IHSS program is a Medi-Cal benefit, which
provides services that enable the recipient to remain in his or her
home. The IHSS program provides personal care services to
approximately 420,000 qualified low-income individuals who are
aged, blind, or disabled.
County social workers determine IHSS eligibility and perform case
management after conducting a standardized in-home assessment of an
individual's ability to perform activities of daily living. Based
on authorized hours and services, IHSS recipients are responsible
for hiring, firing, and directing their IHSS provider(s). In the
majority of cases, recipients choose a relative to provide care.
Prior to July 1, 2012, county public authorities or nonprofit
consortia were designated as "employers of record" for collective
bargaining purposes on a statewide basis, while the state
administered payroll and benefits. However, pursuant to 2012-13
Budget trailer bill SB 1036 (Budget and Fiscal Review Committee),
Chapter 45, Statutes of 2012, collective bargaining
responsibilities in the eight counties participating in the CCI
will start to shift to an IHSS Authority administered by the state.
Background on the CCI: The Budget Act of 2012 enacted the CCI, a
framework for integrating delivery of medical, behavioral and
long-term care services through a single health plan for persons
eligible for both Medicare and Medi-Cal. The CCI is currently
limited to the following eight demonstration counties: Alameda,
Los Angeles, Orange, San Diego, San Mateo, Riverside, San
Bernardino, and Santa Clara. Approximately 65% of IHSS recipients
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reside in the demonstration counties.
As part of the CCI, SB 1036 shifted collective bargaining
responsibilities from local county public authorities or non-profit
consortia in the demonstration counties to the new Statewide
Authority, with specified members and an advisory committee. The
bill also created an IHSS MOE funding requirement for counties,
which replaced the previously existing county share of non-federal
funding of 35%. Under SB 1036, this shift occurs in each county
once enrollment into managed care pursuant to the CCI has been
completed. According to the Department of Health Care Services
(DHCS), this shift was scheduled to have occurred in April 2014.
Need for the bill: According to the author, this bill is necessary
to move to statewide collective bargaining for IHSS providers
despite delays in the implementation of the CCI. While the statute
creating the CCI anticipated roll-out within eight demonstration
counties no earlier than March 1, 2013, delays have resulted the
demonstration being implemented more than a year later in April
2014.
June 2013 budget trailer bill language already delinked the
integration of long-term services and supports into managed care
from the implementation of the integration of Medi-Cal and Medicare
financing. The author argues that it is necessary to also sever
the link between CCI implementation and the creation of the IHSS
Statewide Authority and transfer of employer responsibility to that
authority from local entities.
This bill's cosponsor, the American Federation of State and County
Municipal Employees, notes that the implementation delays have
delayed the transfer of collective bargaining to the state, and as
a result, collective bargaining at the county level has either been
delayed or met with reluctance to engage in bargaining when the
transfer of responsibility is expected to be imminent. The sponsor
writes that several counties have proposed one-year contract
extensions, while others have opposed increases in IHSS spending
because it would permanently increase the county's IHSS MOE.
Writing in support of the bill, Merced County notes that, "the
implementation of the CCI has been significantly delayed, hindering
the shift in bargaining. [This bill] would separate the
commencement of the shift in bargaining from CCI implementation.
Much of the programmatic local control has already shifted to the
State level. We support the implementation of the remaining
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components to allow for better continuity of services."
Opposition: Writing in opposition to this bill, the CalHR states:
Prior to the transition to the Statewide Authority,
the counties and/or local public authorities are
considered the employer of IHSS providers for the
purposes of collective bargaining. The IHSS
Employer-Employee Relations Act (SB 1036 (Senate
Budget and Fiscal Review Committee), Chapter 45,
Statutes of 2012) provides that upon the county
implementation date for the eight demonstration
counties, the Statewide Authority may delegate to
CalHR, responsibility for the day-to-day labor
relations, contract administration, and collective
bargaining.
Currently, CalHR does not have the necessary resources
to assume collective bargaining functions for all 58
counties by January 1, 2015. Furthermore, while the
CCI was delayed for program readiness, the transition
to the CCI has already commenced. The Department of
Health Care Services and the Department of Social
Services can more appropriately address specific
questions on the transition timelines and completion
dates. However, immediate expansion of the
demonstration to all 58 counties before the pilot for
the statewide authority has commenced, defeats the
purpose of the original bill to first initiate
collective bargaining on a pilot basis. Lastly,
advancing the program to all 58 counties defeats the
original intent of SB 1036 and the budget agreement
reached between the Legislature and the Governor.
Prior legislation: SB 94 (Budget and Fiscal Review Committee),
Chapter 37, Statutes of 2013: Enacted changes to existing law
regarding the CCI and de-linked CCI components to allow the
mandatory enrollment of Medi-Cal and Medicare beneficiaries (dual
eligibles) into Medi-Cal managed care, the integration of long-term
services and supports into managed care plans, and the commencement
of the IHSS Statewide Authority, to proceed separately from the CCI
Duals Demonstration Project.
SB 1036 (Budget and Fiscal Review Committee), Chapter 45, Statutes
of 2012: The Human Services budget trailer bill that contained the
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necessary statutory changes to implement the human services
provisions related to the integration of home and community based
and long-term care services, including IHSS, into Medi-Cal managed
care, as specified in the Budget Act of 2012.
SB 1008 (Budget and Fiscal Review Committee), Chapter 33, Statutes
of 2012: Implemented the Duals Demonstration Pilot Projects,
including integration of long-term services and supports.
SB 208 (Steinberg), Chapter 714, Statutes of 2010: Implemented
several changes to the Medi-Cal Program as proposed in the state's
application to renew the state's Section 1115 Medicaid Waiver. Also
gave DHCS the authority to establish the dual eligible beneficiary
demonstration project to give those eligible for Medicare and
Medi-Cal a continuum of services and maximize coordination of
benefits.
Analysis Prepared by : Chris Reefe / HUM. S. / (916) 319-2089
FN: 0004366